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Keywords Prothrombin complex concentrat...

Prothrombin complex concentrate cpb

https://read.qxmd.com/read/37378438/a-rotem-guided-algorithm-aimed-to-reduce-blood-product-utilization-during-neonatal-and-infant-cardiac-surgery
#1
JOURNAL ARTICLE
Aymen N Naguib, Sergio A Carrillo, Marco Corridore, Amee M Bigelow, Ashley Walczak, Nguyen K Tram, Diane Hersey, Mark Galantowicz, Joseph D Tobias
BACKGROUND: Neonates and infants undergoing cardiac surgery tend to receive high volumes of blood products. The use of rotational thromboelastometry (ROTEM® ) has been shown to reduce the administration of blood products in adults after cardiac surgery. We sought to develop a targeted administration of blood products based on ROTEM® to reduce blood product utilization during and after neonatal and infant cardiac surgery. METHODS: We conducted a retrospective review of data from a single center for neonates and infants undergoing congenital cardiac surgery using cardiopulmonary bypass (CPB) from September 2018-April 2019 (control group)...
June 2023: Journal of Extra-corporeal Technology
https://read.qxmd.com/read/37373602/plasma-free-strategy-for-cardiac-surgery-with-cardiopulmonary-bypass-in-infants-10-kg-a-retrospective-propensity-matched-study
#2
JOURNAL ARTICLE
Marco Ranucci, Umberto Di Dedda, Giuseppe Isgrò, Alessandro Giamberti, Mauro Cotza, Noemi Cornara, Ekaterina Baryshnikova
BACKGROUND: Infants < 10 kg undergoing cardiac surgery with cardiopulmonary bypass (CPB) may receive either fresh frozen plasma (FFP) or other solutions in the CPB priming volume. The existing comparative studies are controversial. No study addressed the possibility of total avoidance of FFP throughout the whole perioperative course in this patient population. This retrospective, non-inferiority, propensity-matched study investigates an FFP-free strategy compared to an FFP-based strategy...
June 7, 2023: Journal of Clinical Medicine
https://read.qxmd.com/read/37272063/activated-prothrombin-complex-concentrate-in-pediatric-cardiac-patients-our-early-experience
#3
JOURNAL ARTICLE
Elena Ashikhmina Swan, Nathan J Brinkman, Brian D Lahr, Michael E Nemergut, Joseph A Dearani, Elizabeth H Stephens
BACKGROUND: Pediatric cardiac surgery is associated with abnormal coagulation, bleeding, and nearly ubiquitous transfusions. With the popularization of patient blood management, attempts are being made to decrease liberal transfusions by administering prothrombin complex concentrates (PCCs). The safety and efficacy of PCCs in adult cardiac surgery has been studied extensively, but only few reports address this in children. We performed an observational study focused on transfusion requirements after off-label use of activated PCC Factor Eight Inhibitor Bypassing Activity (FEIBA) as an adjunct to post-cardiopulmonary bypass (CPB) hemostatic protocol...
June 4, 2023: World Journal for Pediatric & Congenital Heart Surgery
https://read.qxmd.com/read/37005203/rotational-thromboelastometry-guided-use-of-synthetic-blood-products-in-cardiac-transplant-patients-a-retrospective-before-after-study
#4
JOURNAL ARTICLE
Kimberly C Li, Matthew A Coley, Anthony Chau, Alexander Dotto, Andrew McMillan, Hsian Chiu, Ronald Ree
OBJECTIVES: Viscoelastic hemostatic assays, such as rotational thromboelastometry (ROTEM), are used increasingly in cardiac surgery to guide transfusion decisions. After separation from cardiopulmonary bypass (CPB), achieving hemostasis rapidly is the main goal before chest closure. The authors hypothesized that introducing a ROTEM-guided factor- concentrate transfusion algorithm would reduce the duration from CPB separation to chest closure during cardiac transplantation. DESIGN: A retrospective cohort study of 21 patients before and 28 patients after implementation of the ROTEM-guided transfusion algorithm who underwent cardiac transplantation...
July 2023: Journal of Cardiothoracic and Vascular Anesthesia
https://read.qxmd.com/read/36919404/comparison-of-prothrombin-complex-concentrate-with-activated-factor-vii-use-for-bleeding-following-cardiopulmonary-bypass-in-children
#5
JOURNAL ARTICLE
John W Benson, Viktor Hraska, John P Scott, Eckehard A E Stuth, Ke Yan, Jian Zhang, Robert A Niebler
OBJECTIVE: This study aims to compare the efficacy and safety of activated recombinant factor VII (rFVIIa) and prothrombin complex concentrate (PCC) in the treatment of bleeding complications following surgery requiring cardiopulmonary bypass (CPB) in children. DESIGN/METHODS: This is a retrospective chart review of a single institution comprising patients aged 0 to 18 years old with congenital heart disease. Patients must have received either PCC or rFVIIa after coming off CPB...
May 2023: World Journal for Pediatric & Congenital Heart Surgery
https://read.qxmd.com/read/36729967/activated-4-factor-prothrombin-complex-concentrate-as-a-hemostatic-adjunct-for-neonatal-cardiac-surgery-a-propensity-score-matched-cohort-study
#6
JOURNAL ARTICLE
Manchula Navaratnam, Julianne M Mendoza, Shiqi Zhang, Derek Boothroyd, Katsuhide Maeda, Komal Kamra, Glyn D Williams
BACKGROUND: Prothrombin complex concentrates are an emerging "off-label" therapy to augment hemostasis after cardiopulmonary bypass (CPB), but data supporting their use for neonatal cardiac surgery are limited. METHODS: We retrospectively reviewed neonates undergoing open heart surgery with first-time sternotomy between May 2014 and December 2018 from a hospital electronic health record database. Neonates who received activated 4-factor prothrombin complex concentrate (a4FPCC) after CPB were propensity score matched (PSM) to neonates who did not receive a4FPCC (control group)...
December 2, 2022: Anesthesia and Analgesia
https://read.qxmd.com/read/35767271/prothrombin-complex-concentrate-vs-plasma-for-post-cardiopulmonary-bypass-coagulopathy-and-bleeding-a-randomized-clinical-trial
#7
RANDOMIZED CONTROLLED TRIAL
Mark M Smith, Darrell R Schroeder, James A Nelson, William J Mauermann, Ian J Welsby, Alberto Pochettino, Beth L Montonye, Chalailak Assawakawintip, Gregory A Nuttall
IMPORTANCE: Post-cardiopulmonary bypass (CPB) coagulopathy and bleeding are among the most common reasons for blood product transfusion in surgical practices. Current retrospective data suggest lower transfusion rates and blood loss in patients receiving prothrombin complex concentrate (PCC) compared with plasma after cardiac surgery. OBJECTIVE: To analyze perioperative bleeding and transfusion outcomes in patients undergoing cardiac surgery who develop microvascular bleeding and receive treatment with either PCC or plasma...
September 1, 2022: JAMA Surgery
https://read.qxmd.com/read/35144945/efficacy-of-prothrombin-complex-concentrate-pcc-versus-fresh-frozen-plasma-ffp-in-reducing-perioperative-blood-loss-in-cardiac-surgery-study-protocol-for-a-non-inferiority-randomised-controlled-trial
#8
JOURNAL ARTICLE
Lijian Pei, Chen Sun, Hong Lv, Yuelun Zhang, Jia Shi
OBJECTIVE: To explore whether prothrombin complex concentrate (PCC) is not inferior to fresh frozen plasma (FFP) with regard to reducing perioperative blood loss in patients undergoing cardiac surgery under cardiopulmonary bypass (CPB). SETTING: Fu Wai Hospital, and Peking Union Medical College Hospital in China. PARTICIPANTS: Patients undergoing elective coronary artery bypass grafting, valve replacement or valvuloplasty under CPB, between 18 and 80 years old, will be included...
February 10, 2022: BMJ Open
https://read.qxmd.com/read/34779523/emergency-cardiac-surgery-in-patients-on-oral-anticoagulants-and-antiplatelet-medications
#9
REVIEW
Rami Akhrass, Marc Gillinov, Faisal Bakaeen, Deena Akras, Scott J Cameron, Jay Bishop, Samir Kapadia, Lars Svensson
BACKGROUND: Emergency surgery, blood transfusion, and reoperation for bleeding have been associated with increased operative morbidity and mortality. The recent increased use of direct oral anticoagulants and antiplatelet medications has made the above more challenging. In addition, cardiopulmonary bypass (CPB), with its associated hemodilution, fibrinolysis, and platelet consumption, may exacerbate the pre-existing coagulopathy and increase the risk of bleeding. AIM: The aim of this study was to examine available literature with regard to treating patients who are on the above medications and require emergency cardiac surgery...
January 2022: Journal of Cardiac Surgery
https://read.qxmd.com/read/34215339/factor-viii-inhibitor-bypass-activity-feiba-for-the-reduction-of-transfusion-in-cardiac-surgery-a-randomized-double-blind-placebo-controlled-pilot-trial
#10
JOURNAL ARTICLE
Valerie A Sera, Ann E Stevens, Howard K Song, Victor M Rodriguez, Frederick A Tibayan, Miriam M Treggiari
BACKGROUND: Uncontrolled bleeding after cardiac surgery can be life-threatening. Factor eight inhibitor bypassing activity (FEIBA) is a prothrombin complex concentrate empirically used as rescue therapy for correction of refractory bleeding diathesis post-cardiopulmonary bypass (CPB). FEIBA used as rescue therapy for bleeding diathesis after CPB has been associated with a low incidence of complications and a reduction in transfusion requirement and re-exploration. The feasibility and efficacy of early administration of FEIBA after the termination of CPB have not been studied in a prospective randomized trial...
July 2, 2021: Pilot and Feasibility Studies
https://read.qxmd.com/read/34152599/administration-of-fibrinogen-concentrate-combined-with-prothrombin-complex-maintains-hemostasis-in-children-undergoing-congenital-heart-repair-a-long-term-propensity-score-matched-study
#11
JOURNAL ARTICLE
Corinna Velik-Salchner, Helmuth Tauber, Verena Rastner, Werner Pajk, Markus Mittermayr, Dieter Wally, Juliane Kilo, David Vondrys, Dietmar Fries, Josef Fritz, Werner Streif
BACKGROUND: Bleeding is a common problem in children with congenital heart disease undergoing major cardiac surgery requiring cardiopulmonary bypass (CPB). Little is known about optimal management with blood products. OBJECTIVE: To investigate clinical outcome and hemostatic effects of fibrinogen concentrate (FC) in combination with prothrombin complex concentrate (PCC) versus standard treatment with fresh frozen plasma (FFP) in children undergoing cardiac surgery...
June 21, 2021: Acta Anaesthesiologica Scandinavica
https://read.qxmd.com/read/33798057/changes-in-coagulation-and-fibrinolysis-systems-during-the-perioperative-period-of-acute-type-a-aortic-dissection
#12
JOURNAL ARTICLE
Chuzhi Zhou, Yanzhen Li, Yalan Yan, Dongjie Feng, Minxin Wei, Junmin Wen
BACKGROUND: Acute type A aortic dissection (ATAAD) has a high risk of perioperative bleeding and often requires extensive blood product infusions. Analysis of the changes in coagulation and fibrinolysis is both helpful for proper treatment and an improved prognosis. The present study investigated the changes in the coagulation and fibrinolysis systems during the perioperative period of ATAAD. METHODS: Twenty-two patients with ATAAD were included in this study. After diagnosis, all patients underwent ascending aorta replacement, aortic arch replacement, and implantation of a special stented endovascular graft...
March 3, 2021: Heart Surgery Forum
https://read.qxmd.com/read/32620960/a-0-6-protamine-heparin-ratio-in-cardiac-surgery-is-associated-with-decreased-transfusion-of-blood-products
#13
JOURNAL ARTICLE
Anne L M Goedhart, Bastiaan M Gerritse, Thijs C D Rettig, Martijn W A van Geldorp, Sander Bramer, Nardo J M van der Meer, Leandra J Boonman-de Winter, Thierry V Scohy
OBJECTIVES: In cardiac surgery, adequate heparinization is necessary to prevent thrombus formation in the cardiopulmonary bypass (CPB). To counteract the heparin effect after weaning from CPB, protamine is administered. The optimal protamine/heparin ratio is still unknown. METHODS: In this before-after study, we evaluated the effect of a 0.6/1-protamine/heparin ratio implementation as of May 2017 versus a 0.8/1-protamine/heparin ratio on the 12-h postoperative blood loss and the amount of blood and blood component transfusions (fresh frozen plasma, packed red blood cells, fibrinogen concentrate, platelet concentrate and prothrombin complex concentrate) after cardiac surgery...
September 1, 2020: Interactive Cardiovascular and Thoracic Surgery
https://read.qxmd.com/read/32133581/thrombin-generation-and-bleeding-in-cardiac-surgery-a-clinical-narrative-review
#14
REVIEW
John Fitzgerald, Robert McMonnies, Aidan Sharkey, Peter L Gross, Keyvan Karkouti
This narrative review discusses the role of thrombin generation in coagulation and bleeding in cardiac surgery, the laboratory methods for clinical detection of impaired thrombin generation, and the available hemostatic interventions that can be used to improve thrombin generation. Coagulopathy after cardiopulmonary bypass (CPB) is associated with excessive blood loss and adverse patient outcomes. Thrombin plays a crucial role in primary hemostasis, and impaired thrombin generation can be an important cause of post-CPB coagulopathy...
June 2020: Canadian Journal of Anaesthesia
https://read.qxmd.com/read/30182421/analysis-of-the-structural-and-mechanical-effects-of-procoagulant-agents-on-neonatal-fibrin-networks-following-cardiopulmonary-bypass
#15
JOURNAL ARTICLE
K Nellenbach, N A Guzzetta, A C Brown
Essentials The standard of care (SOC) for treating neonatal bleeding is transfusion of adult blood products. We compared neonatal clots formed with cryoprecipitate (SOC) to two procoagulant therapies. The current SOC resulted in clots with increased stiffness and decreased fibrinolytic properties. Procoagulant therapies may be a viable alternative to SOC treatment for neonatal bleeding. SUMMARY: Background Bleeding is a serious complication of neonates undergoing cardiopulmonary bypass (CPB) and associated with substantial morbidity and mortality...
November 2018: Journal of Thrombosis and Haemostasis: JTH
https://read.qxmd.com/read/29198634/intraoperative-administration-of-4-factor-prothrombin-complex-concentrate-reduces-blood-requirements-in-cardiac-transplantation
#16
JOURNAL ARTICLE
Gina H Sun, Visal Patel, Ingrid Moreno-Duarte, Farhad Zahedi, Eric Ursprung, Greg Couper, Fred Y Chen, Ian J Welsby, Raymond Comenzo, Grace Kao, Frederick C Cobey
OBJECTIVE: Assessing the efficacy of intraoperative 4-factor prothrombin complex concentrate (4F-PCC) use in blood product utilization, time to chest closure, intensive care unit (ICU) and hospital length of stay (LOS), thromboembolic complications, renal injury and mortality in left ventricular assist device (LVAD) patients on home anticoagulation therapy with warfarin, undergoing orthotopic heart transplantation (OHT). DESIGN: Retrospective analysis of OHT patients at Tufts Medical Center from May 2013 to October 2016...
February 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://read.qxmd.com/read/28789610/management-of-refractory-bleeding-post-cardiopulmonary-bypass-in-an-acute-heparin-induced-thrombocytopenia-type-ii-renal-failure-patient-who-underwent-urgent-cardiac-surgery-with-bivalirudin-angiox-%C3%A2-anticoagulation
#17
JOURNAL ARTICLE
Kimberly Hassen, Maria R Maccaroni, Haytham Sabry, Smitangshu Mukherjee, Shankari Serumadar, Inderpaul Birdi
Acute heparin-induced thrombocytopenia (HIT) patients present a myriad of anticoagulation management challenges, in clinical settings where unfractionated heparin (UFH) is the traditional drug of choice. UFH use in cardiac surgery is a known entity that has been subject to rigorous research. Research has, thus, led to its unparalleled use and the development of well-established protocols for cardiac surgery. In comparison to UFH, bivalirudin use for acute HIT patients requiring urgent cardiac surgery with cardiopulmonary bypass (CPB) is still in its infancy...
April 2018: Perfusion
https://read.qxmd.com/read/28393462/current-use-of-factor-concentrates-in-pediatric-cardiac-anesthesia
#18
REVIEW
Nina A Guzzetta, Glyn D Williams
Excessive bleeding following pediatric cardiopulmonary bypass is associated with increased morbidity and mortality, both from the effects of hemorrhage and the therapies employed to achieve hemostasis. Neonates and infants are especially at risk because their coagulation systems are immature, surgeries are often complex, and cardiopulmonary bypass technologies are inappropriately matched to patient size and physiology. Consequently, these young children receive substantial amounts of adult-derived blood products to restore adequate hemostasis...
July 2017: Paediatric Anaesthesia
https://read.qxmd.com/read/27402424/perioperative-management-of-pediatric-en-bloc-combined-heart-liver-transplants-a-case-series-review
#19
JOURNAL ARTICLE
Manchula Navaratnam, Ann Ng, Glyn D Williams, Katsuhide Maeda, Julianne M Mendoza, Waldo Concepcion, Seth A Hollander, Chandra Ramamoorthy
BACKGROUND: Combined heart and liver transplantation (CHLT) in the pediatric population involves a complex group of patients, many of whom have palliated congenital heart disease (CHD) involving single ventricle physiology. OBJECTIVE: The purpose of this study was to describe the perioperative management of pediatric patients undergoing CHLT at a single institution and to identify management strategies that may be used to optimize perioperative care. METHODS: We did a retrospective database review of all patients receiving CHLT at a children's hospital between 2006 and 2014...
October 2016: Paediatric Anaesthesia
https://read.qxmd.com/read/27268940/a-snapshot-of-coagulopathy-after-cardiopulmonary-bypass
#20
REVIEW
Judith Höfer, Dietmar Fries, Cristina Solomon, Corinna Velik-Salchner, Julia Ausserer
Cardiac surgery involving cardiopulmonary bypass (CPB) is often associated with important blood loss, allogeneic blood product usage, morbidity, and mortality. Coagulopathy during CPB is complex, and the current lack of uniformity for triggers and hemostatic agents has led to a wide variability in bleeding treatment. The aim of this review is to provide a simplified picture of the data available on patients' coagulation status at the end of CPB in order to provide relevant information for the development of tailored transfusion algorithms...
September 2016: Clinical and Applied Thrombosis/hemostasis
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